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目的探讨射频消融(RFCA)治疗儿童室上性心动过速(PSVT)的临床疗效及安全性。方法对36例PSVT患儿常规进行心内电生理检查查明PSVT发病机制,确定消融靶点,采用温度控制方式射频消融。结果经心内电生理检查显示房室折返性心动过速(AVRT)22例,房室结折返性心动过速(AVNRT)14例,均手术即获成功,术中有2例患儿在放置希氏束电极时产生一过性度房室传导阻滞(AVB),未经处理自行恢复窦性心律,2例术后发生完全性右束支传导阻滞(CRBBB),于1~2d后恢复正常,术后1例(2.7%)AVNRT患儿9个月后复发,再次手术获得成功,所有患儿未发生永久性度AVB及心包填塞等严重并发症。结论在操作熟练的心脏介入中心,儿童PSVT的射频消融治疗与成人相比一样安全、有效,AVNRT消融后复发可能与医师惧怕患儿房室结发育不成熟致消融能量及消融时间趋于保守等因素有关。
Objective To investigate the clinical efficacy and safety of radiofrequency ablation (RFCA) in the treatment of children with supraventricular tachycardia (PSVT). Methods Thirty-six children with PSVT underwent routine electrophysiological examination to ascertain the pathogenesis of PSVT, determine the target of ablation, and use temperature control to radiofrequency ablation. Results Intracardiac electrophysiological examination showed that 22 cases of atrioventricular reentrant tachycardia (AVRT) and 14 cases of atrioventricular nodal reentrant tachycardia (AVNRT) were successful in operation. There were 2 cases in operation His bundle beam produced a transient degree of atrioventricular block (AVB), sinus rhythm was restored without treatment, and complete right bundle branch block (CRBBB) occurred in 2 cases. After 1 ~ 2 days Returned to normal. One case (2.7%) of AVNRT patients relapsed after 9 months, and the successful operation was again. All the patients had no serious AVB and pericardial tamponade complications. Conclusions In the operation of skilled cardiac intervention center, children with PSVT radiofrequency ablation treatment as safe and effective compared with adults, AVNRT recurrence after ablation may be physician afraid of children with atrioventricular node maturation caused by ablation of energy and ablation time tends to be conservative Factors related.